Practical Prevention—Testicular Cancer Strikes Young
In my experience, most young men are not aware that they may be vulnerable to ]]>testicular cancer]]> even though this cancer usually strikes men who are 15 to 35 years old. It is not only the most common cancer in this age group but also the leading cancer killer in this age group.
Cyclist Lance Armstrong and skater Scott Hamilton are two young, nationally known athletes who have been treated for testicular cancer. Though the disease can affect older men, it occurs much less frequently after age 40.
Catch It Early
The good news for young men is that testicular cancer is highly curable when caught early. Recent treatment advances have led to a much lower death rate from this disease than in the past. The 5-year survival rate now exceeds 95%, compared to 63% in 1963. Today, early detection and treatment are the keys to success in curing testicular cancer.
Note: The 5-year survival rate measures the number of patients alive five years after diagnosis—the closest measure we have to a cure rate.
Who Is at Risk?
No one knows what causes testicular cancer and scientists are not sure why the incidence of this cancer in the US has increased markedly in recent years. When looking at men of all ages, testicular cancer is still relatively rare. There are about 7600 new cases each year. For unexplained reasons, however, the rate has almost doubled since the 1930s and continues to climb.
We do know that young men between the ages of 15 to 35 are at highest risk for the disease.
Other factors that may increase your odds of getting testicular cancer include:
- Race: White, especially of Scandinavian heritage
- Having a testicle that has not fully descended into the scrotum, even if surgery was done to remove it or bring it down
- A testicle that did not descend into the scrotum until after age six
- Testicles that are small or irregularly shaped
- Family history of testicular cancer, especially in a brother or father
- Previous testicular cancer
- ]]>Klinefelter's syndrome]]> (a genetic) condition
What to Look For
Testicular cancer usually causes a hard, painless lump in the testicle. Symptoms can include:
- Painless enlargement, usually noticed during bathing or after a minor trauma
- Painful enlargement, possibly result of bleeding or infarction in the tumor, occurs in 30% to 50% of patients
- A scrotum that feels heavy or swollen
- Enlargement or hardening of the testes
- Growth of breast tissue
These changes are usually found when a man does a self-exam of his testicles like the one described in the next section. Sometimes a lump is discovered after a blow to a testicle, or by a sexual partner.
More advanced testicular cancer may cause symptoms such as:
- Leg swelling
- Back pain
- Coughing up blood
- Trouble breathing
Finding It Earlier Is Better
I find that men are often reluctant to report a lump or other possible signs of testicular cancer. In one study, the duration of symptoms before diagnosis ranged from 17 to 87 weeks. Since testicular cancers grow quickly, any delay may make a difference in the treatment options that are available and their chances of success.
So promptly see your doctor if you discover a lump or notice other possible signs of testicular cancer. Your doctor will ask you about your symptoms and perform a physical exam. Special tests may help confirm or deny testicular cancer and check for any signs of that the cancer has spread. These tests may include:
Regular testicular self-examination is a small effort that could save your life. Starting in the early teens, men and boys should check themselves for testicular cancer on a monthly basis. Pick a date that is easy to remember, such as the first or last day of each month. Some men find the exam easier to do after a warm bath or shower. At your next visit with your doctor, go over the steps of the self-exam.
Here are the basics:
- Gently and thoroughly roll one testicle, then the other, between the thumb and first two fingers of both hands.
- Feel for any lumps or hardened areas, an enlargement of the testicle, or a change in its consistency. With several exams, you will learn how the tissue normally feels so you can quickly notice any changes.
- Report any unusual findings to your doctor.
Keeping Cancer in Check
It's a good idea to have your provider check your testicles during school or sports exams or as part of routine physicals. Men who are at high risk for testicular cancer should schedule regular exams with a doctor. In addition, all men should perform a testicular self-exam once a month.
American Cancer Society
Cancer Research and Prevention Foundation
National Cancer Institute
The Testicular Cancer Resource Center
Canadian Cancer Society
Casciato DA. Manual of Clinical Oncology . 5th. ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.
Kinkade S. Testicular cancer. Am Fam Physician . 1999 May 1:2539-2550.
Sonpavde G. What to do when you discover testicular cancer. Postgrad Med . 1999 Apr;229-241.
Testicular cancer: increasing in incidence and curability. Patient Care . 2000 May 30:18-38.
Last reviewed December 2008 by ]]>Igor Puzanov, MD]]>
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